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PANCE Key Terms > Cardiology > Flashcards

Cardiology Flashcards

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1
Q

What side effect might make a patient stop taking an ACEI?

A

Cough

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2
Q

Define orthostatic hypotension

A

A drop in systolic BP of >20 mmhg when standing up

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3
Q

You feel a pulse that seems to be vibrating, what term do you use to describe it?

A

Thrill

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4
Q

What are three things in your differential if you have a paradoxical pulse?

A

Cardiac tamponade, pericarditis, obstructive Lung disease

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5
Q

On palpating, what size is normal for the aorta?

A

Less than 3cm

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6
Q

A fixed consistent split S2 should make you think of what diagnosis?

A

Atrial septal defect

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7
Q

A pathological S3 is most commonly associated with what diagnosis?

A

CHF

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8
Q

If you hear a midsystolic click you should immediately be thinking about what diagnosis?

A

Mitral stenosis

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9
Q

An opening snap on auscultation should make you think of what diagnosis?

A

Mitral stenosis

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10
Q

A continuous murmur most likely involves what area of the heart?

A

Most likely a septal defect

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11
Q

You hear an continuous machine-like murmur, why is the most likely diagnosis?

A

Patent ductus arteriosus

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12
Q

List three medications which may be used for pharmological stress test

A

Adenosine, dobutamine, dipyridamole, Persantine

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13
Q

What is the gold standard for diagnosing CAD?

A

Cardiac catheterization

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14
Q

Define stage I HTN according to JNC 7

A

Systolic: 140-159
Diastolic: 90-99

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15
Q

What is the treatment goal for a diabetic with HTN?

A

130/80

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16
Q

What is the MCC of secondary HTN?

A

CKD

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17
Q

No matter what medicaitons you use you are having trouble keeping a patient’s BP under control. You also notice hyperpigmented skin and truncal obesity. What is the most likely diagnosis?

A

Cushing’s Disease

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18
Q

List three S/S which will likely be included in a description of a patient with a pheochromocytoma

A

thin, diaphoretic, tachycardic, agitated, hypertensive

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19
Q

You have a patient with a diagnosis of pheochromocytoma, while waiting for surgery, should you use an alpha or beta blocker?

A

Alpha blocker, NEVER use pure beta blocker

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20
Q

A young boy comes to you office. He has an elevated BP but no femoral pulses can be palpated. What is the most likely diagnosis?

A

Coarctation of the aorta

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21
Q

according to the CDC, what is the range for a normal BMI?

A

18.5-24.9

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22
Q

What is the first line medication treatment for stage I HTN?

A

Thiazide diuretic

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23
Q

After a thiazide diuretic, what medication should you start in a hypertensive patient who also has DM?

A

ACEI or ARB

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24
Q

Following an MI, what medication should be prescribed to treat HTN?

A

Beta Blocker

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25
paroxysmal nocturnal dyspnea should make you think of what diagnosis?
CHF
26
What is the most common cause of CHF?
CAD
27
What ejection fraction is typical for a patient with CHF
35-40%
28
What is the most likely diagnosis for a young man who experiences sudden death while playing sports?
Hypertrophic Cardiomyopathy
29
Bat wing vessels or Kerley B links on a CXR should make you think of what diagnosis?
CHF
30
a BNP below what level rules out CHF?
<100
31
What is the therapeutic range for INR following a mechanical valve replacement?
2.5-3.5
32
What is the first line IV inotropic agent when dealing with cardiogenic shock?
Dopamine
33
What diagnosis is most likely in an IV drug user with a nre heart murmur and fever
Endocarditis
34
List two diagnoses which require antibiotic prophylaxis for "dirty procedures"
prosthetic valve, valve repair with any prosthetic material, prior endocarditis, congenital cyanotic heart defect
35
Does a patient with mitral valve prolapse require prophylactic antibiotics for dental work?
No, recent change move mitral valve prolapse from high risk to medium risk
36
What are the three major criteria for endocarditis
2 positive blood cultures, positive transesophageal echo, new murmur
37
Which are painful and found on the fingers and toes, osler nodes or janeway lesions?
osler nodes
38
list the 4 minor criteria for diagnosing enodcarditis
fever, embolic event, immunological event, 1 positive blood culture
39
What are the 5 components of tetralogy of fallot?
overriding aorta, RVH, ventricular septal defect, pulmonary stenosis, right sided aortic arch
40
What is the gold standard for diagnosing myocarditis?
Myocardial biopsy
41
Where do most aortic dissections occur?
the ascending or descending thoracic aorta
42
a patient complains of severe pleuritic CP that is relived with sitting and leaning forward. what is the most likely diagnosis?
pericarditis
43
What is the first line medical treatment for pericarditis?
aspirin and NSAIDs
44
What is the name of the syndrome that involves pericarditis several days after a MI?
Dressler syndrome
45
A patient presents to the ED with CP, an EKG shows diffuse ST elevations in almost all of the leads, what is the most likely diagnosis?
Pericarditis
46
Define paradoxical pulse
there is a large difference in pulse pressure between inhalation and exhalation
47
define pulses alternans
EKG waveform changes from beat to beat
48
What is the definitive treatment for cardiac tamponade?
Pericardiocentesis
49
On physical exam, you hear a harsh systolic murmur along the right sternal border, what is the most likely diagnosis
aortic stenosis
50
A wide pulse pressure with a blowing diastolic decrescendo murmur at the right 2nd intercostal space should make you think of what diagnosis?
aortic regurgitation
51
what is the best locations to hear problems with the aortic valve?
2nd right intercostal space
52
where is disease of the pulmonary valve best heard?
2nd left intercostal space
53
What two antibiotics are used for empiric treatment of endocarditis?
Vancomycin and ceftriaxone together are first line empiric Tx
54
What two valvular issues do patients with Marfan's syndrome often have?
Aortic regurgitation and Mitral prolapse
55
What are the two main causes of aortic stenosis?
congenital bicuspid valve and calcification of the valve secondary to CAD
56
An elderly patient presents with dyspnea, angina, and syncope on exertion. The EKG is normal, what is the most likely diagnosis?
Aortic stenosis
57
On auscultation you hear a harsh, blowing, pansystolic murmur at the apex, what is the most likely diagnosis?
mitral regurgitation
58
You suspect mitral regurgitation, what is the most accurate way to prove your diagnosis?
tranesophageal echo
59
a patient with Mitral prolapse will often have what physical characteristics?
often a thin female
60
What is the best patient position to hear aortic regurge and aortic stenosis?
sitting up and leaning forward
61
What is Tietze syndrome?
costochondritis
62
Are most pulmonary valve problems congenital or acquired?
95% congenital
63
What is the therapeutic range for INR following an organic valve replacement?
2-3
64
a 60 year old male presents to the ER with severe dizziness and back pain. his BP is dropping and you can feel and abdominal pulsatile mass on physical exam. what is the most likely diagnosis?
ruptured aortic aneurysm
65
In a patient with aortic stenosis, how will the PMI be displaced?
laterally d/t LVH
66
A patient complains of severe crushing chest pain. EKG shows ST segment elevations. all labs including troponins and CK-MB are negative. what is the most likely diagnosis?
Prinzmetal's angina
67
a questions about prinsmetal's angina will often contain what key thing in the patient's history?
cocaine use
68
name two things that would constitute a positive stress test
a drop in BP, a new arrhythmia, an increase in angina symptoms, ST depressions
69
Are ulcers from venous insufficiency painful or painless?
Painless
70
A patient has just received a cardiac stent. How long will he be on aspirin and clopidogrel?
1 year
71
Where is disease of the mitral valve best heard?
at the apex
72
What is the initial treatment for a MI?
MONA > morphine, oxygen, nitroglycerin, aspirin
73
Clot busting drugs should be used within 3 hours of which two cardiac events?
STEMI and new LBBB
74
List three catastrophic complications of a MI
Papillary muscle rupture, myocardial wall rupture, left ventricular aneurysm
75
an EKG shows a regular heart rate of 200 BPM, QRS is narrow, what is the most likely diagnosis?
SVT
76
Acute endocarditis is most commonly cauased by what organism?
staph aureus
77
list three congenital heart diseases?
Atrial septal defect, ventricular septal defect, coarctation of the aorta, patent ductus arteriosus, tetralogy of fallot
78
what is the most common cause of an atrial septal defect
patent foramen ovale
79
Where on your patient should you listen for the murmur associated with an atrial septal defect?
at the second or third interspace
80
a CXR shows a "3" sign with notching of the ribs, what is the most likely diagnosis?
coarctation of the aorta
81
what is the appropriate treatment for a patent ductus arteriosus?
indomethacin
82
a Blalock procedure is used to correct what congenital heart condition?
tetralogy of fallot
83
You hear a loud, harsh pulmonary murmur along the left sternal border, what is the most likely diagnosis?
ventricular septal defect

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